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Home My Public Portal About10632 BOGUE ST_Plumbing__ DBS-17( APPLICATION FOR PLUMBING PERMIT DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING 10632 Fkngi3a St JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN,SUPT OF BUILDING _ LOCALITY FOR APPLICANT- TO FILL IN NEAREST:CROSS El Monte Ave o OWNER Miller-& Price" • ` DISTRICT NO. GR`OUF ZONE I READY FOR INSPECTION AAIDR -ADDRESS' 8640- -E-: Las Tunas Blvde -� c1rYSa21 Gabr9elQt TEL. NO.•AT (ry-3VVI INDUSTRIAL WA TE APPROVAL PLUMBER Standard Plumbing Co a INSPECTION RECORD ADDRESS d3'3:3 F. Fleren ce Ave;; ' �k+- el ✓� CITY Reil" `n •• TEL. NO. LU 7-1124 LICENSE NO. 39243 NUMBER TYPE OF FIXTURE OR-ITEM - FEE' .. vOFv WATER CLOSET (TOILET) @ $1.00 s2 00 BATH TUB" @ $1.00 00 SHOWER - @ $1.00 LAVATORY (WASH BASIN) @ $1.00 - KITCHEN SINK @ $1.00 DISHWASHER - @ $1.00* LAUNDRY-TUB OR TRAY ,@ $1.00 CLOTHES WASHER @' $1.00 WATER HEATER @ $1.00 SG►t" GAS SYSTEM @ $1.00 APPROVALS. !� n DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK A � •� PERMIT, $ 7 00 ROUGH PLUMBING GAS PIPING TOTAL FEE 11 00 GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT 'THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND. STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY GELES OU AN TATE OF CALIFORNIA OR THAT I M -LEGAL ER HE OV UTILITY CO.NOTIFIED DESCRIBED RESIDENTI SIGNATURE S / OF PERMITTEE FINAL 5"/� ;f JOHN-A. LAMBIE COUNTY ENGINEERVALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR CK. H.G. CASH Lot ##4 2 0 9'-%. M- 1 7 3 1 1 .0 0 In J :NORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ►'1;ereb" a""'n that I have a certificate of consent to self 76A667A insure, ora certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or,a certified copy thereof (Sec 3800, b C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N ompany ❑ Certified copy is hereby furnished. S FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / Certified copy is filed with the county building ins ec- ADDRESS tion de artment. NUMBER FIXTURE OR ITEM @ FEE LOCALITY �` L Date '� Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER (This section'need not be completed if the work involved by SHOWER / the permit is forone hundred dollars (5100)or less.) LAVATORY MAIL ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CIT CINO so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR /,N H Date Applicant CLOTHES WASHER ADDRESS GC -- NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- CITY TEL. N LAWN SPRINKLER SYSTEM with comply with such provisions or this permit-shall be STATE deemed revoked WATER HEATER LICENSE NO. 6 CLAS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY el hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYS EM FINAL O DATE ; VALIDATION V • License Number � Lic Class �> �` 09 e FINALS O Contract Date �j BY V ❑ IL I am exempt under Sec. IL BAP C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$- 0 r77 Signature J TOTAL FEE (� SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 11 Professions Code): City Tel. No. 1 0 0,fit.A ❑ I, as owner of the property, will do the work and theT o u o o o,� structure is not intended or offered for sale (Section ► 7044, Business and Professions Code). v O, S Q CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for O Q, Q U the performance of the work for which this permit is issued 10 17 6,_ (Sec. 3097, Civ C ). , Lender's Name Lender's Address I certify that I have read this application and state that the ► above information is correct I agree to comply with all County ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abov endo ed p pe ty r inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S nature of Permittee Date 1 V WORK• 'COMPENSATION DECLARATION y hereby, affirm"that I have a certificate of consent to self,in- 20-00260PW 4/87 APPLICATION FOR PLUMBING* PERMIT j 7Z sure,or a certificate:o ) f Workers'Compensation Insurance,or CE 817 REV 8/86 ce tifieid�c�opy t�hery>of, Se3800, Lab C.) �' "• ,t} t`r ��J PictJo:L 'i✓ —•'Copany,f yk'°r'%�" r�l'-�\'�' CQQUNTY OF=LOS AGELESI DEPT. OF PUBLIC WORKS ..t,'`�4 G:yi}'•J t 4�iCY t'y``tY q ertified copy is hereby furnished,l u a 1,f,}, *(UA x- „�"«_ f f5k° s,;;f.'• �:a- ;j ji FOR•APPLICANT TO FILL IN(PRINT OR BUILDING J/ ADDRESS r )C_1 Certified copy'is filed•with'tFfe�` xiTdrng=inspection' !"'� department y,r NUMBER FIXTURE OR ITEM @ FEE J f w:" a �`fit \. •�ii �: �i`` ,• •' Applicant � ri...• r ' +'_=y,,r. WATER CLOSET(TOILET) Datei • NEAREST % 3 ��KE .-�' BATH TUB CROSS ST ' CE TIFICATE OF EXEMPTION•'FROM WORRS' COMPENSATION INSURANCE . ' "�r\� }�}"ft 4•,E, •.,,) w'n - -, � SHOWER. : OWNER .. (This section need not be completed if theworkinvolved by' MAIL ;~ ' )-' the permit'is for one hundred dollors($100)or,less.) LAVATORY ADDRESS : I'certify'that in the performance of the work for which this per- SINK CITY t< j�) YECt NO" mit is issued, I shall not employ any person in any manner so f;.;l,I'�IF �" as to become subject to the Workers'Compensation Laws. DISHWASHER �? y� CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS T r NOTICE TO APPLICANT.,If, after making this Cerfificate of Ex- SWIMMING POOL RECEPTOR. - emption,you should become subject to the Workers'Compen: CITY` i,i s cation provisions of the Labor Code, you.must forthwith comp= LAWN SPRINKLER SYSTEM jr1j '•,'+(h "y!;Y,;;�7o,`,;e;;;^ rl EL NO Iy with such provisions or this permit shall be deemed revok- STATE~ �, , } LIC .ed WATER HEATER LICENSE NO `ti., _„p ( CLASS ! LICENSED CONTRACTORS-DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am•licensed under provisions of Chapter GAS SYSTEM OUTLETS c+ 9(commencing with Section,7000)•of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. j' DATE License Number � i i—, Lic. Class — /f, ; ;✓^” , Y�f % FINAL ' M" I' Contractor. D ��-.�,.�L �i•r�)'�. ate `r-+ BY��- I am exe'm'pt under Sec •B.BP C for this reason Plan check fee ► J A Date; PLUMBING PERMIT ISSUING FEE$ �Af 1Q;jai W Signature TOTAL FEE- tt-� t�•i;�°'lat `i SINGLE FAMILY ) Plan check applicant - -i1N � HOME OWNER-BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Name j k`^•"i` ; • Law for the following reason (Section 7031 5,, Business and t r4 Professions Code): Address t I, as owner of the property, will do,the work and the City Tel No 4 structure is not-intended or offered for sale(Section 7044, i Business and Professions Code). , CONSTRUCTION LENDING AGENCY k- 1 I hereby affirm that there is a construction lending agency for the'performance of the work for which,this permit is issued (Sec. 3097., Civ:,C ). 3 Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all County ordinances and State jaws regulating Plumbing, and hereby ► authorize representatives of this County to enter upon the ¢ above-men tioned•property for inspection purposes. , y. � ',f��W'r�:.' +i;;r''� '"�• f ''< °'�` SEE REVERSE,FOR EXPLANATORY LANGUAGE fStgn f freofPef`rt"iittee `l ` —Dbte [-,•,. f